People with very low cholesterol levels are at increased risk of developing stomach cancer, according to a study published in the International Journal of Cancer.

The study involved 2,600 residents of Hisayama, Japan, who were followed for 14 years. Gastric cancers developed in 97 subjects. After accounting for age and gender, stomach cancer rates rose significantly with descending cholesterol level. For example, among subjects with the highest cholesterol levels, the gastric cancer rate was the equivalent of 2.1 cases per 1000 persons per year; among those with the lowest cholesterol, the rate was 3.9 per 1000 persons per year.

Patients with low serum cholesterol should consider periodic gastrointestinal examination for the prevention of stomach cancer.

Low cholesterol has been earlier linked to depression, anxiety and suicide in both men and women. Another earlier report has also shown that people with cholesterol level below 180 had twice the risk of brain hemorrhage as compared to those with cholesterol levels of 230.

Oncology
The diabetes drug pioglitazone does not appear to be associated with an increased risk of bladder cancer as had been previously suggested; however, new data indicate a possible increased risk of prostate and pancreatic cancer. The findings were published July 21 in the Journal of the American Medical Association.

Diabetes
Erectile dysfunction (ED) is a marker of undiagnosed diabetes and should be a trigger to begin diabetes screening, especially in middle-aged men, suggests a cross-sectional survey published in the July/August issue of the Annals of Family Medicine.

Infectious diseases
The introduction of opioid agonist therapy, also known as methadone maintenance treatment, has led to a dramatic decrease in HIV- and drug-related mortality in HIV-positive injection drug users, reported new research presented at the 8th International AIDS Society (IAS) Conference.

Rheumatology
Certolizumab pegol, a humanized anti-TNF antibody fragment conjugated to polyethylene glycol, is effective for treating early rheumatoid arthritis (RA) with poor prognostic factors, suggests the C-OPERA study published online in Annals of the Rheumatic Diseases.

Cardiology eMedinewS

Coronary computed tomography angiography (CTA) may be useful in determining whether patients who present with chest pain will develop acute coronary syndrome (ACS), suggests new research published July 28 in the Journal of the American College of Cardiology.

In low-to-intermediate risk patients who presented with possible acute coronary syndrome (ACS) and had a coronary CT angiography (CCTA) scan to detect stenosis, those on statin therapy were less likely to have a high-risk plaque and more likely to have coronary artery calcification, reported an analysis of the Multicenter Study to Rule Out Myocardial Infarction by Cardiac Computed Tomography (ROMICAT-II). The results were presented at the Society of Cardiovascular Computed Tomography (SCCT) 2015 Annual Scientific Meeting.

Pediatrics eMedinewS

PediatricsObesity
A pediatric obesity intervention that focused on frequent, low-dose family support was able to effectively reduce excess weight in mild to moderately overweight children. The findings were published online July 20 and in the August issue of Pediatrics.

PediatricsRheumatology
Past antibiotic exposure may be associated with newly diagnosed juvenile idiopathic arthritis (JIA), which suggests that alterations in the human microbiome may be implicated in the development of the disease, reported a case-control study published online July 20 in Pediatrics.

Dr KK Spiritual Blog

Allopathic Medical Vrat

There was a time everybody in India, especially the women, used to observe regular fasts. In my childhood, I saw my mother not only observing fasts herself but also insisting upon my sisters to fast once a week, an extra fast once in a month and observe 2 Navratras in a year of 9 days each. This sums up to be around 80 fasts in a year.

When I go back to my childhood, I remember the fast used to be one day of avoiding cereals altogether. We were allowed to eat chapatis made of Kuttu flour, singharha flour, samak rice and chaulai daal (all fruits).

As children, we could never understand the meaning and/or significance of fasts. Today India is fast becoming a hub of diabetes, heart diseases and insulin resistance. All these disease conditions are linked with not observing fasts or eating high carb diets every day.

The major culprit is eating carbohydrates, especially, refined carbohydrates. Recollecting our mythology when only one king Raja Dashrath died of heart attack, it only signifies that our mythological lifestyle was preventing heart diseases in India. The western culture, which is now spreading fast in India, involves eating carbohydrates, especially, refined carbohydrates (white sugar, white rice, white maida) every day.

I recently conducted a survey and found that women who observe weekly fast or vrat have lower incidence of metabolic syndrome. But, today, girls and women are failing to observe ‘vrat’ or ‘spiritual vrata’.

Therefore, they must be made to understand the same in the language of a ‘medical vrat’. A simpler version of ‘vrat’ can be – not eating carbohydrates at all once in a week and replacing them with fruits and vegetables.

I usually suggest that once in a week, one should eat only fruits and vegetables and at the most can have milk, curd. If still someone has desires, can have besan ka chila.

Lesson: Make sure to remember that clarithromycin (macrolide) 500 mg twice–daily for 7 days is not only effective in maxillary sinusitis but also in other sinusitis.

Events

Dr Good Dr Bad

Situation: A middle–aged patient was found to have central obesity.

Dr Bad: It is normal.

Dr Good: Rule out diabetes.

Lesson: Findings of a prospective cohort study (1989–2007) of 4,193 men and women 65 years of age and older in the Cardiovascular Health Study suggest that among older adults, overall and central adiposity and weight gain during middle age and after the age of 65 years were associated with risk of diabetes (JAMA. 2010 Jun 23;303(24):2504-12).

(Copyright IJCP)

eMedi Quiz

A 5-year-old boy passed 18 loose stools in last 24 hour and vomited twice in last 4 hour. He is irritable but drinking fluids. The optimal therapy for this child is:

Yesterday’s Mind Teaser: A couple, with a family history of beta thalassemia major in a distant relative has come for counselling. The husband had HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is.

The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

This views are published by BMJ. They are not scientific and not based on facts and merit. IMA does not agree with the views.

It looks that it's easier to publish any views in BMJ than in Indian journals, especially if it relates to health care system of India.

White coats are not symbol of doctor or professionalism. They are worn so that your cloths do not get infected. You are suppose to wash then daily. If you reuse them you are likely to spread infections.

If you are going to wear half sleeve aprons then the full sleeve shirt underneath will get infected.

We need to be proactive so that we do end up with negative stories by Indians in foreign media.

Past antibiotic exposure may be associated with newly diagnosed juvenile idiopathic arthritis (JIA), which suggests that alterations in the human microbiome may be implicated in the development of the disease. The results of the case-control study were published online July 20 in Pediatrics.

Executive committee member and IMA office-bearer Dr Shivkumar Utture said, "The problem is that relatives of patients have become fearless. Those who assault doctors have realised that no police action will be taken against them. Not a single person known to have attacked a doctor has been convicted yet and this has led to lawlessness among them. The police needs to set a deterrent, only then will such cases stop." (DNA)

Sunday multi location Video CME

Details of Presto’s representatives who are the primary contact person for the various sites.

Once there was a king who received a gift of two magnificent falcons. They were peregrine falcons, the most beautiful birds he had ever seen. He gave the precious birds to his head falconer to be trained. Months passed, and one day the head falconer informed the king that though one of the falcons was flying majestically, soaring high in the sky, the other bird had not moved from its branch since the day it had arrived.

The king summoned healers and sorcerers from all the land to tend to the falcon, but no one could make the bird fly. He presented the task to the member of his court, but the next day, the king saw through the palace window that the bird had still not moved from its perch.

Having tried everything else, the king thought to himself, “May be I need someone more familiar with the countryside to understand the nature of this problem.” So he cried out to his court, “Go and get a farmer.” In the morning, the king was thrilled to see the falcon soaring high above the palace gardens. He said to his court, “Bring me the doer of this miracle.”

The court quickly located the farmer, who came and stood before the king. The king asked him, “How did you make the falcon fly?” With his head bowed, the farmer said to the king, “It was very easy, your highness. I simply cut the branch where the bird was sitting.”

Moral: We are all made to fly — to realize our incredible potential as human beings. But at times we sit on our branches, clinging to the things that are familiar to us. The possibilities are endless, but for most of us, they remain undiscovered. We conform to the familiar, the comfortable, and the mundane. So for the most part, our lives are mediocre instead of exciting, thrilling and fulfilling. Let us learn to destroy the branch of fear we cling to and free ourselves to the glory of flight.

Media

Quote of the Day

The roots of all goodness lie in the soil of appreciation for goodness. Dalai Lama

It is a dream situation which will bring all dedicated IMA workers and leaders to be in touch and know each other views and get motivated. Our National president and the Digital emperor Secretary General have made possible this intellectual unity and deserve all our appreciations. Prof Dr JA Jayalal, Secretary IMA Tamil Nadu (2010-13)

Dear friends, Season’s greetings. Kudos to excellent leadership initiative (Organ Donation & Leadership Skill Upgradation) taken up by our sincere committed "team-IMA" leaders spearheaded by Dr A Marthanda Pillai and Dr KK Aggarwal. Every man in his journey will face and develop relationship either good or bad, with incidents, things and humans. Out of these three types of relationships, the most difficult and tumultuous is managing the human relationships. To be a leader, one has to master these skills. Once again thanks to our national president and Hony Secy Gen, for giving this opportunity to all of us. With best regards: Dr C Srinivasa Raju

Wellness Blog

3 simple ways for a restful sleep

Cut down on caffeine: Caffeine drinkers may find it harder to fall asleep. Even a single cup of coffee in the morning may lead to a sleepless night. Caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night. Because caffeine withdrawal can cause headaches, irritability, and extreme fatigue, it may be easier to cut back gradually rather than to go cold turkey. Those who can’t or don’t want to give up caffeine should avoid it after 2 pm, or noon if they are especially caffeine–sensitive.

Stop smoking or chewing tobacco: Nicotine is a central nervous system stimulant that can cause insomnia. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime.

Limit alcohol intake: Alcohol depresses the nervous system, so a nightcap may seem to help some people fall asleep. Alcohol suppresses REM sleep, and the soporific effects disappear after a few hours. Alcohol also worsens snoring and other sleep breathing problems

IMA Humor

Santa calls up the doc at 2 AM. "Doc, my wife is having severe abdomen pain. I think it's her appendix."

"What nonsense!" says the doc sleepily.

"I took out your wife's appendix two years ago. Go back to sleep."

Five minutes later, the phone rings and its Santa again.

"Doc, I'm sure it's her appendix."

"Oh God!" the doctor groaned.

"Did you ever hear of anyone having a second appendix?"

"No...," says Santa. "But I'm sure you must have heard of someone having a second wife!!!!"

Allergic reactions including fall in blood pressure, dyspnea, cutaneous reactions and in isolated cases reaching as far as anaphylactic shock, even when the patient has shown no hypersensitivity to previous administration of immunoglobulins.

Technological advancements have helped bridge distances in our vast country and have made possible, seamless communication between people based in different cities. Keeping in line with the dynamics of the changing world, the Indian Medical Association, the only representative voluntary organization of doctors of the modern scientific system of medicine has decided to go digital. IMA aims to amplify its messages to both its 2.5-lakh doctor members and to the public at large through the digital medium.

Addressing the press, Padma Shri Awardee Dr. (Prof.) A Marthanda Pillai, National President and Padma Shri Awardee Dr KK Aggarwal, Hon. Secretary General, IMA in a joint statement said, “IMA is in the process of becoming a paperless Association. It has been our constant endeavor to make the medical profession more transparent and effective along with raising large-scale public health awareness about matters of National importance. We echo our Prime Minister’s belief in the potential of a Digital India and will be using this as a medium to communicate with both doctors and the public.”

IMA has already created a digital group called Team IMA, which will make daily communication between over 2500 Central Council Members possible. Since the beginning of this year, over 2 lakh doctor members of the IMA are being sent daily updates on the organization and key health matters through the medium of text messages and emails.

To make IMA’s functioning more effective, the association has also tied up with M/s Presto and BSNL communication to make regular Video CMEs possible across 23 different locations in the country.

The IMA headquarters in New Delhi have been equipped with a video conferencing facility where family physicians can communicate with each other. IMA will also be launching a first of its kind Tele Medicine Rural Health Consultation service on 16th August, 2015 where the IMA Dhule Branch will connect with the IMA headquarters through video conferencing.

A health education weekly programme from 3:00 to 4:00 p.m. every Thursday will also be started by the Association which will allow doctors to interact with Dr A Marthanda Pillai and Dr KK Aggarwal, through a live webcast on the IMA website on issues of common interest for doctors and patients and healthcare facilitators.

Recently the IMA has also started an online TB notification facility for doctors as well as a rare blood group directory for people in need of emergencies.

As its next steps, IMA will be rolling out a website on organ donation where every doctor will be able to pledge to donate their organs.